TY - JOUR
T1 - If we gave away mammograms, who would get them? A neighborhood evaluation of a no-cost breast cancer screening program
AU - Klassen, Ann C.
AU - Smith, Ann L.M.
AU - Meissner, Helen I.
AU - Zabora, James
AU - Curbow, Barbara
AU - Mandelblatt, Jeanne
N1 - Funding Information:
1This work was supported in part through investigator-initiated Grant R01 CA66065 from the National Cancer Institute of the National Institutes of Health.
PY - 2002
Y1 - 2002
N2 - Background. Low- and no-cost mammography programs have become a widespread strategy to increase access to breast cancer screening in low-income populations. However, rigorous evaluations of who remains unscreened in communities with these programs are lacking. We conducted a case-control study of African American older women in East Baltimore, Maryland, comparing attendees at a no-cost program to friends and neighbors not using no-cost venues. Methods. We recruited 288 women ages 50 and older, who attended a no-cost program at Johns Hopkins Hospital, to complete a 11/2 h home interview, answering semistructured and open-ended questions about cancer and health and a wide range of social and psychological items. For each case, we recruited one friend or neighbor, within 5 years of age, not receiving no-cost screening, to complete a similar control interview. Matched case-control analyses were used to compare program attendees to nonattendees within the target community. Results. Women using the no-cost program at least once were generally more poorly screened than their neighborhood control prior to the program, but had better recent screening history 3 years after the program began. In multivariate analyses, program attendees were more likely to have >$10,000 annual income (OR = 2.34, 95% CI 1.55,3.61), more likely to have had more children (OR = 1.13, 95% CI 1.04,1.24), and less likely to have health insurance (OR = 0.42, 95% CI 0.25,0.68). They were more likely to see a female primary care provider (OR = 1.82, 95% CI 1.24,2.70) and to see multiple providers (OR = 3.38, 95% CI 1.52,8.60). Conclusions. Low-cost screening intervention programs reach women who might otherwise not receive screening. However, within target communities, improved partnerships with specific types of primary care providers could reach additional women.
AB - Background. Low- and no-cost mammography programs have become a widespread strategy to increase access to breast cancer screening in low-income populations. However, rigorous evaluations of who remains unscreened in communities with these programs are lacking. We conducted a case-control study of African American older women in East Baltimore, Maryland, comparing attendees at a no-cost program to friends and neighbors not using no-cost venues. Methods. We recruited 288 women ages 50 and older, who attended a no-cost program at Johns Hopkins Hospital, to complete a 11/2 h home interview, answering semistructured and open-ended questions about cancer and health and a wide range of social and psychological items. For each case, we recruited one friend or neighbor, within 5 years of age, not receiving no-cost screening, to complete a similar control interview. Matched case-control analyses were used to compare program attendees to nonattendees within the target community. Results. Women using the no-cost program at least once were generally more poorly screened than their neighborhood control prior to the program, but had better recent screening history 3 years after the program began. In multivariate analyses, program attendees were more likely to have >$10,000 annual income (OR = 2.34, 95% CI 1.55,3.61), more likely to have had more children (OR = 1.13, 95% CI 1.04,1.24), and less likely to have health insurance (OR = 0.42, 95% CI 0.25,0.68). They were more likely to see a female primary care provider (OR = 1.82, 95% CI 1.24,2.70) and to see multiple providers (OR = 3.38, 95% CI 1.52,8.60). Conclusions. Low-cost screening intervention programs reach women who might otherwise not receive screening. However, within target communities, improved partnerships with specific types of primary care providers could reach additional women.
KW - Breast cancer screening
KW - Evaluation
KW - Intervention
KW - Low income
KW - Mammography
UR - http://www.scopus.com/inward/record.url?scp=0036353023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036353023&partnerID=8YFLogxK
U2 - 10.1006/pmed.2001.0956
DO - 10.1006/pmed.2001.0956
M3 - Article
C2 - 11749092
AN - SCOPUS:0036353023
SN - 0091-7435
VL - 34
SP - 13
EP - 21
JO - Preventive Medicine
JF - Preventive Medicine
IS - 1
ER -